Skip to content

Advertisement

You're viewing the new version of our site. Please leave us feedback.

Learn more

BMC Genomics

Open Access

The effect of low level leukocytospermia on oxidative stress markers in infertile men

  • Saad Alshahrani1, 2,
  • Ashok Agarwal1, 3Email author,
  • Mourad Assidi3, 4,
  • Adel M. Abuzenadah3, 4,
  • Ahmet Ayaz1 and
  • Rakesh Sharma1
BMC Genomics201415(Suppl 2):P56

https://doi.org/10.1186/1471-2164-15-S2-P56

Published: 2 April 2014

Background

Leukocytospermia is defined as presence of ≥1 x 106 WBC/mL of the seminal ejaculate. The World Health Organization (WHO) recommends peroxidase staining as the standard method for the detection of semen leukocytes [1, 2]. The incidence of leukocytospermia ranges from 10 - 20% among infertile men. Both morphologically abnormal spermatozoa and leukocytes produce reactive oxygen species (ROS). The polymorphonuclear neutrophils and macrophages are the main components of seminal leukocytes which can generate significantly higher (>100-fold) quantities of ROS, overwhelming the ROS-scavenging mechanisms in seminal plasma and resulting in oxidative stress and damage to spermatozoa. The presence of very few activated leukocytes can produce a detectable amount of ROS [3, 4]. Therefore, even a very low number of leukocytes in the sperm suspension may influence the integrity of sperm and, consequently, the outcome of assisted reproduction treatment [5]. Leukocytes contributed directly to ROS production and release and indirectly through the leukocyte-stimulated sperm. Such stimulation may be via direct contact or mediated by soluble products released by the leukocytes. The goal of our study was to assess the effect of low level leukocytospermia on semen quality and oxidative stress markers in infertile men.

Materials and methods

In this prospective study, 211 infertile patients with no history of genital tract infections or varicocele were included. Semen samples were examined for sperm concentration, motility, seminal leukocyte levels (Endtz test) [2], reactive oxygen species (ROS) by chemiluminescence assay, and sperm DNA damage by TUNEL test. Patients were divided into 3 groups based on their seminal leukocyte levels. Group 1: no seminal leukocytes (n = 153); group 2: low level leukocytospermia (0.1 -1 X 106 WBC/mL; n = 22); and group 3: leukocytospermia (>1 X 106 WBC/mL; n = 36).

Results

22 patients (10%) had high and 36 (18.3%) had low seminal leukocytes levels (Table 1). Conventional semen parameters between the 3 groups were similar. Patients with low level leukocytospermia had significantly higher levels of ROS (P = 0.001) and sperm DNA damage (P <0.05) compared to non leukocytospermic group. There was no significant difference in ROS levels between the two groups of leukocytospermia (groups 2 and 3).
Table 1

Semen parameters and its association with leukocytospermia

Parameters

Seminal leukocytes (X 106 WBC/mL)

 

No leukocytes

0.1 – 1 WBC

> 1 WBC

Concentration (X 106/mL)

53.04 ± 56.76

69.04 ± 80.72

39.35 ± 39.98

Motility (%)

48.37 ± 17.42

47.33 ± 25.74

49.23 ± 19.56

Normal morphology (%)

3.42 ± 3.12

3.56 ± 3.16

4.14 ± 3.79

ROS (RLU/ sec)

116.7 (49; 550.3)

944.8 (127; 3315.4)a

61286.8 (6905; 234876)a,b

DNA damage (%)

19.89 ± 17.31

26.47 ± 19.64a

24.60 ± 17.47

Results are presented as mean ± SD for all the parameters except ROS which is presented as median (25th; 75th percentile).

aP <0.05 statistically significant compared to non leukocytospermic group.

bP <0.05 statistically significant compared to low level leukocytospermic group.

Conclusions

Patients presenting with low levels of leukocytes have a high oxidative stress. Although these patients are not categorised as leukocytospermic by current WHO guidelines, however these men may benefit by treatment with antibiotics or antioxidant supplements to reduce ROS induced sperm DNA damage and improve therefore their chances of fertility.

Authors’ Affiliations

(1)
Center for Reproductive Medicine, Cleveland Clinic
(2)
College of Medicine, Salman Bin Abdulaziz University
(3)
Center of Excellence in Genomic Medicine Research, KAU
(4)
KACST Technology Innovation Center for Personalized Medicine, King Abdulaziz University

References

  1. World Health Organization: WHO Laboratory manual for the examination of human semen and sperm-cervical mucus interaction. 1999, Cambridge, Cambridge University Press, 4thGoogle Scholar
  2. World Health Organization: WHO laboratory manual for the examination and processing of human semen. 2010, Geneva, Switzerland, FifthGoogle Scholar
  3. Plante M, de Lamirande E, Gagnon C: Reactive oxygen species released by activated neutrophils, but not by deficient spermatozoa, are sufficient to affect normal sperm motility. Fertil Steril. 1994, 62: 387-393.PubMedGoogle Scholar
  4. Sharma R, Pasqualotto F, Nelson D, Thomas A, Agarwal A: Relationship between seminal white blood cells counts and oxidative stress in men treated at an infertility clinic. J Androl. 2001, 22: 575-583.PubMedGoogle Scholar
  5. Henkel R, Kierspel E, Stalf T, Mehnert C, Menkveld R, Tinneberg HR, Schill WB, Kruger TF: Effect of reactive oxygen species produced by spermatozoa and leukocytes on sperm functions in non-leukocytospermic patients. Fertil Steril. 2005, 83: 635-642.View ArticlePubMedGoogle Scholar

Copyright

© Alshahrani et al; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Advertisement